Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Clinical and Molecular Allergy
Published in: Clinical and Molecular Allergy 1/2020

01-12-2020 | Candidiasis | Review

Oral health in asthmatic patients: a review

Asthma and its therapy may impact on oral health

Authors: Federica Gani, Marco Caminati, Fabio Bellavia, Andrea Baroso, Paolo Faccioni, Paolo Pancera, Veronica Batani, Gianenrico Senna

Published in: Clinical and Molecular Allergy | Issue 1/2020

Login to get access

Abstract

Different drugs used to treat asthma, such as beta 2 agonists and inhaled steroids, may promote a higher risk of caries, dental erosion, periodontal disease and oral candidiasis. This article reviews the evidences of mechanisms involved in oral diseases in patients affected by asthma. The main mechanism involved is the reduction of salivary flow. Other mechanisms include: acid pH in oral cavity induced by inhaled drugs (particularly dry powder inhaled), lifestyle (bad oral hygiene and higher consumption of sweet and acidic drinks), gastroesophageal reflux, and the impairment of local immunity. In conclusion asthma is involved in the genesis of oral pathologies both directly and indirectly due to the effect of the drugs used to treat them. Other cofactors such as poor oral hygiene increase the risk of developing oral diseases in these patients. Preventive oral measures, therefore, should be part of a global care for patients suffering from asthma.
Literature
1.
Reddel HK, FitzGerald JM, Bateman ED, Bacharier LB, Becker A, Brusselle G, et al. GINA 2019: a fundamental change in asthma management: Treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents. Eur Respir J. 2019;53(6).
2.
3.
Ernst P, Suissa S. Systemic effects of inhaled corticosteroids. Curr Opin Pulm Med. 2012;18(1):85–9.CrossRefPubMed
4.
Lipworth BJ. Risks versus benefits of inhaled β2-agonists in the management of asthma. Drug-Safety. 1992;7(1):54–70.CrossRefPubMed
5.
6.
Thomas MS, Parolia A, Kundabala M, Vikram M. Asthma and oral health: a review. Aust Dent J. 2010;55(2):128–33.CrossRefPubMed
7.
8.
Widmer RP. Oral health of children with respiratory diseases. Paediatr Respir Rev. 2010;11(4):226–32.CrossRefPubMed
9.
Marsh PD, Do T, Beighton D, Devine DA. Influence of saliva on the oral microbiota. Periodontol 2000. 2016;70(1):80–92.CrossRefPubMed
10.
Camelo-Castillo AJ, Mira A, Pico A, Nibali L, Henderson B, Donos N, et al. Subgingival microbiota in health compared to periodontitis and the influence of smoking. Front Microbiol. 2015;6:119.CrossRefPubMedPubMedCentral
11.
12.
Segata N, Haake SK, Mannon P, Lemon KP, Waldron L, Gevers D, et al. Composition of the adult digestive tract bacterial microbiome based on seven mouth surfaces, tonsils, throat and stool samples. Genome Biol. 2012;13(6):R42.CrossRefPubMedPubMedCentral
13.
Sag C, Ozden FO, Acikgoz G, Anlar FY. The effects of combination treatment with a long-acting beta2-agonist and a corticosteroid on salivary flow rate, secretory immunoglobulin A, and oral health in children and adolescents with moderate asthma: a 1-month, single-blind clinical study. Clin Ther. 2007;29(10):2236–42.CrossRefPubMed
14.
del-Río-Navarro BE, Corona-Hernández L, Fragoso-Ríos R, Berber A, Torres-Alcántara S, Cuairán-Ruidíaz V, et al. Effect of salmeterol and salmeterol plus beclomethasone on saliva flow and IgA in patients with moderate-persistent chronic asthma. Ann Allergy Asthma Immunol. 2001;87(5):420–3.CrossRefPubMed
15.
16.
Dahl R, Engel M, Dusser D, Halpin D, Kerstjens HAM, Zaremba-Pechmann L, et al. Safety and tolerability of once-daily tiotropium Respimat(®) as add-on to at least inhaled corticosteroids in adult patients with symptomatic asthma: a pooled safety analysis. Respir Med. 2016;118:102–11.CrossRefPubMed
17.
Vogelberg C, Engel M, Laki I, Bernstein JA, Schmidt O, El Azzi G, et al. Tiotropium add-on therapy improves lung function in children with symptomatic moderate asthma. J Allergy Clin Immunol. 2018;6(6):2160–2.CrossRef
18.
Fukushima C, Matsuse H, Tomari S, Obase Y, Miyazaki Y, Shimoda T, et al. Oral candidiasis associated with inhaled corticosteroid use: comparison of fluticasone and beclomethasone. Ann Allergy Asthma Immunol. 2003;90(6):646–51.CrossRefPubMed
19.
Ellepola AN, Samaranayake LP. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis. 2001;7(4):211–6.CrossRefPubMed
20.
Kurt E, Yildirim H, Kiraz N, Orman A, Metintas M, Akgun Y, et al. Oropharyngeal candidiasis with dry-powdered fluticasone propionate: 500 microg/day versus 200 microg/day. Allergol Immunopathol. 2008;36(1):17–20.CrossRef
21.
Mullaoglu S, Turktas H, Kokturk N, Tuncer C, Kalkanci A, Kustimur S. Esophageal candidiasis and Candida colonization in asthma patients on inhaled steroids. Allergy Asthma Proc. 2007;28(5):544–9.CrossRefPubMed
22.
Salas MMS, Nascimento GG, Huysmans MC, Demarco FF. Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis. J Dent. 2015;43(1):42–50.CrossRefPubMed
23.
Shaw L, Dlaigan YH, Smith A. Childhood asthma and dental erosion. ASDC J Dent Child. 2000;67(2):102–6.PubMed
24.
Dugmore CR, Rock WP. Asthma and tooth erosion Is there an association? Int J Paediatr Dent. 2003;13(6):417–24.CrossRefPubMed
25.
26.
Barron RP, Carmichael RP, Marcon MA, Sàndor GKB. Dental erosion in gastroesophageal reflux disease. J Can Dent Assoc. 2003;69(2):84–9.PubMed
27.
Strużycka I, Lussi A, Bogusławska-Kapała A, Rusyan E. Prevalence of erosive lesions with respect to risk factors in a young adult population in Poland-a cross-sectional study. Clin Oral Investig. 2017;21(7):2197–203.CrossRefPubMed
28.
Harding SM. Gastroesophageal reflux, asthma, and mechanisms of interaction. Am J Med. 2001;111(8):8S–12S.CrossRefPubMed
29.
Pauwels A. Dental erosions and other extra-oesophageal symptoms of gastro-oesophageal reflux disease: evidence, treatment response and areas of uncertainty. United Eur Gastroenterol J. 2015;3(2):166–70.CrossRef
30.
Farag ZHA, Awooda EM. Dental erosion and dentin hypersensitivity among adult asthmatics and non-asthmatics hospital-based: a preliminary study. Open Dent J. 2016;10:587–93.CrossRefPubMedPubMedCentral
31.
Löe H, Brown LJ. Early onset periodontitis in the United States of America. J Periodontol. 1991;62(10):608–16.CrossRefPubMed
32.
Mehta A, Sequeira PS, Sahoo RC, Kaur G. Is bronchial asthma a risk factor for gingival diseases? A control study. N Y State Dent J. 2009;75(1):44–6.PubMed
33.
McDerra EJ, Pollard MA, Curzon ME. The dental status of asthmatic British school children. Pediatr Dent. 1998;20(4):281–7.PubMed
34.
Stensson M, Wendt L-K, Koch G, Oldaeus G, Ramberg P, Birkhed D. Oral health in young adults with long-term, controlled asthma. Acta Odontol Scand. 2011;69(3):158–64.CrossRefPubMed
35.
Moraschini V, Calasans-Maia JA, Calasans-Maia MD. Association between asthma and periodontal disease: a systematic review and meta-analysis. J Periodontol. 2018;89(4):440–55.PubMed
36.
Ferreira MKM, Ferreira RO, Castro MML, Magno MB, Almeida AP, Fagundes APCPSC, et al. Is there an association between asthma and periodontal disease among adults? Systematic review and meta-analysis. Life Sci. 2019;223:74–87.CrossRefPubMed
37.
Han E-R, Choi IS, Kim H-K, Kang Y-W, Park J-G, Lim J-R, et al. Inhaled corticosteroid-related tooth problems in asthmatics. J Asthma. 2009;46(2):160–4.CrossRefPubMed
38.
Heffler E, Madeira LNG, Ferrando M, Puggioni F, Racca F, Malvezzi L, et al. Inhaled corticosteroids safety and adverse effects in patients with asthma. J Allergy Clin Immunol. 2018;6(3):776–81.CrossRef
39.
Shen T-C, Chang P-Y, Lin C-L, Wei C-C, Tu C-Y, Hsia T-C, et al. Risk of periodontal disease in patients with asthma: a nationwide population-based retrospective cohort study. J Periodontol. 2017;88(8):723–30.CrossRefPubMed
40.
Mehtonen IT, Rantala AK, Hugg TT, Jaakkola MS, Jaakkola JJK. Dental caries is associated with lower respiratory tract infections: a population-based cohort study. Respir Med. 2019;158:1–5.CrossRefPubMed
41.
Bjerkeborn K, Dahllof G, Hedlin G, Lindell M, Modéer T. Effect of disease severity and pharmacotherapy of asthma on oral health in asthmatic children. Eur J Oral Sci. 1987;95(2):159–64.CrossRef
42.
Eloot AK, Vanobbergen JN, De Baets F, Martens LC. Oral health and habits in children with asthma related to severity and duration of condition. Eur J Paediatr Dent. 2004;5(4):210–5.PubMed
43.
Alavaikko S, Jaakkola MS, Tjäderhane L, Jaakkola JJK. Asthma and caries: a systematic review and meta-analysis. Am J Epidemiol. 2011;174(6):631–41.CrossRefPubMed
44.
Choi H, Bae K-H, Lee J-W. Association between age at asthma diagnosis and tooth loss. Acta Odontol Scand. 2018;76(7):466–72.CrossRefPubMed
45.
Milano M, Lee JY, Donovan K, Chen J-W. A cross-sectional study of medication-related factors and caries experience in asthmatic children. Pediatr Dent. 2006;28(5):415–9.PubMed
46.
Reddy DK, Hegde AM, Munshi AK. Dental caries status of children with bronchial asthma. J Clin Pediatr Dent. 2003;27(3):293–5.PubMed
47.
Wogelius P, Poulsen S, Sørensen HT. Use of asthma-drugs and risk of dental caries among 5 to 7 year old Danish children: a cohort study. Commun Dent Health. 2004;21(3):207–11.
48.
Bozejac BV, Stojšin I, Ðuric M, Zvezdin B, Brkanić T, Budišin E, et al. Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD. J Appl Oral Sci. 2017;25(5):506–14.CrossRefPubMedPubMedCentral
49.
Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation allergic rhinitis and its impact on asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020;145(1):70–80.CrossRefPubMed
50.
Chuang CY, Sun HL, Ku MS. Allergic rhinitis, rather than asthma, is a risk factor for dental caries. Clin Otolaryngol. 2018;43(1):131–6.CrossRefPubMed
Metadata
Title
Oral health in asthmatic patients: a review
Asthma and its therapy may impact on oral health
Authors
Federica Gani
Marco Caminati
Fabio Bellavia
Andrea Baroso
Paolo Faccioni
Paolo Pancera
Veronica Batani
Gianenrico Senna
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Clinical and Molecular Allergy / Issue 1/2020
Electronic ISSN: 1476-7961
DOI
https://doi.org/10.1186/s12948-020-00137-2

Other articles of this Issue 1/2020

Clinical and Molecular Allergy 1/2020 Go to the issue

Review

Allergic reactions to genus Morus plants: a review

Correspondence

Rich at risk: socio-economic drivers of COVID-19 pandemic spread

Research

Evidence for eosinophil and IL-17 mediated inflammation in allergic rhinitis

Case Report

Near-fatal anaphylaxis with Kounis syndrome caused by Argas reflexus bite: a case report

Review

Vitamin D and Covid-19: an update on evidence and potential therapeutic implications

Research

Association of 25-hydroxy vitamin D with asthma and its severity in children: a case–control study